Hey Robb, this person said gluten free diets are bogus!

167 Comments

Abraham had a common question the other day, here it is:

I recently came across this post on the website skeptoid.com. This guy named Brian Dunning says that gluten-free diets aren’t the gato’s meow (on this podcast: http://skeptoid.com/episodes/4239 ). He says that there is no sound evidence for avoiding gluten for general wellness, your thoughts?

I’m drawing a line in the sand with this post.

I cannot devote a response to everyone of of these, I’ll never get anything productive done and, well it’s just boring at some point. So, I’m going to lay out some paramaters for how/if I’ll comment on stuff like this. I will not comment unless the individual is talking about molecular biology mechanism of action in grain intolerance. If I do not see some of these following terms:

  • TLR4
  • GPR43
  • NOD1
  • CXCR3
  • Zonulin
  • Transglutaminase

I’m not taking the time to comment because the person talking about gluten/grain intolerance can not even sit down at the table for a chat. Mr. Dunning slid in under the wire by mentioning transglutaminase, then misses the boat from there. Let’s look at this from molecular mechanism, then some anthropological data, then a survey of sorts.

Mechanisms

Alessio Fasano, MD has put forward a proposed mechanism involving gluten/grains for all autoimmune disease.  The scientific American piece is for the lay reader, folks with a scientific background should check this one out:

Scandinavian Journal of Gastroenterology, 2006; 41: 408 Á/419

Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac

Objective. Little is known about the interaction of gliadin with intestinal epithelial cells and the mechanism(s) through which gliadin crosses the intestinal epithelial barrier. We investigated whether gliadin has any immediate effect on zonulin release and signaling. Material and methods. Both ex vivo human small intestines and intestinal cell monolayers were exposed to gliadin, and zonulin release and changes in paracellular permeability were monitored in the presence and absence of zonulin antagonism. Zonulin binding, cytoskeletal rearrangement, and zonula occludens-1 (ZO-1) redistribution were evaluated by immunofluorescence microscopy. Tight junction occludin and ZO-1 gene expression was evaluated by real-time polymerase chain reaction (PCR). Results. When exposed to gliadin, zonulin receptor-positive IEC6 and Caco2 cells released zonulin in the cell medium with subsequent zonulin binding to the cell surface, rearrangement of the cell cytoskeleton, loss of occludin-ZO1 protein Á/protein interaction, and increased monolayer permeability. Pretreatment with the zonulin antagonist FZI/0 blocked these changes without affecting zonulin release. When exposed to luminal gliadin, intestinal biopsies from celiac patients in remission expressed a sustained luminal zonulin release and increase in intestinal permeability that was blocked by FZI/0 pretreatment. Conversely, biopsies from non-celiac patients demonstrated a limited,transient zonulin release which was paralleled by an increase in intestinal permeability that never reached the level of permeability seen in celiac disease (CD) tissues. Chronic gliadin exposure caused down-regulation of both ZO-1 and occludin gene expression. Conclusions. Based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.

Mat Lalonde has helped me stay on top of this stuff. Gluten attaches to the transpost molecule, CXCR3. This causes a release of zonulin which disolves the tight junction between intestinal epithelial cells (enterocytes) and THIS opens the door for autoimmunity and systemic inflammation. Take a second look at that highlighted piece above:

Based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.

Interpretation? Significance?

Everyone has CXCR3, everyone transports gluten into the enterocytes, everyone experiences gut irritation from gluten. I’ll wager ALL grains, but I’ll get to that later. Now we have evidence that dietary lectins (like gluten) appear to cause insulin resistance:

BMC Endocr Disord. 2005 Dec 10;5:10.Agrarian diet and diseases of affluence–do evolutionary novel dietary lectins cause leptin resistance?

BACKGROUND: The global pattern of varying prevalence of diseases of affluence, such as obesity, cardiovascular disease and diabetes, suggests that some environmental factor specific to agrarian societies could initiate these diseases.

PRESENTATION OF THE HYPOTHESIS: We propose that a cereal-based diet could be such an environmental factor. Through previous studies in archaeology and molecular evolution we conclude that humans and the human leptin system are not specifically adapted to a cereal-based diet, and that leptin resistance associated with diseases of affluence could be a sign of insufficient adaptation to such a diet. We further propose lectins as a cereal constituent with sufficient properties to cause leptin resistance, either through effects on metabolism central to the proper functions of the leptin system, and/or directly through binding to human leptin or human leptin receptor, thereby affecting the function.

TESTING THE HYPOTHESIS: Dietary interventions should compare effects of agrarian and non-agrarian diets on incidence of diseases of affluence, related risk factors and leptin resistance. A non-significant (p = 0.10) increase of cardiovascular mortality was noted in patients advised to eat more whole-grain cereals. Our lab conducted a study on 24 domestic pigs in which a cereal-free hunter-gatherer diet promoted significantly higher insulin sensitivity, lower diastolic blood pressure and lower C-reactive protein as compared to a cereal-based swine feed. Testing should also evaluate the effects of grass lectins on the leptin system in vivo by diet interventions, and in vitro in various leptin and leptin receptor models. Our group currently conducts such studies.

IMPLICATIONS OF THE HYPOTHESIS: If an agrarian diet initiates diseases of affluence it should be possible to identify the responsible constituents and modify or remove them so as to make an agrarian diet healthier.

So, this is a nicely performed clinical trial on pigs, who happen to be great models for human metabolism due to similar endocrine function and the fact they to are opportunistic omnivores. The highlighted piece above is also critical to consider, and where epidemiology shits-the-bed. They put forward a hypothesis, in this case that grain lectins lead to insulin resistance. this was born of the observational studies done with the Kitavans and the fact they developed metabolic problems when upon the introduction of neolithic foods.

So, the pig study is great, how about a human study? Glad you asked:

Diabetologia. 2007 Sep;50(9):1795-807. Epub 2007 Jun 22.A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.

AIMS/HYPOTHESIS: Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones.

METHODS: Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic (‘Old Stone Age’) diet (n = 14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose(0-120)) and plasma insulin AUC (AUC Insulin(0-120)) in OGTTs.

So, we have an example of going from an observational theory, to a clinical trial with pigs, to a trial with humans. The Folks fed a Paleo diet showed markedly improved glucose tolerance (they started off Type 2 diabetics, finished “normal”) while the other group, which started as Type 2 diabetics, were fed a grain based Mediterranean diet, showed NO improvement in glucose tolerance.

Back to the original question about Brian Dunnings OPINION about gluten. I see no commentary on any of these mechanisms, no refutation of these findings, no alternate hypothesis that BETTER fits the data at hand. that’s a damn big problem when you go about proclaim “this thing is or is not a problem.”

Anthropological considerations

Now, let’s take a quick look at some anthropological considerations, in this case a comparison of hunter gatherers and agriculturalists. This study is a microcosm of the transition from Hunter Gatherer to Agriculturalist. It twas NOT a good thing for our health. Folks ignorant of this fact…well, it’s like the refrain from law enforcement “Ignorantia juris non excusat-Ignorance of the law does not excuse.” but it DOES result in folks like me needing to actually do the research the Brian should have done before commentating on this subject.  Brian takes a stab at an anthropological approach in this way:

The history of human culture is closely tied to the history of bread. Bread was one of our earliest portable foods, which made it possible to take long journeys.

Not trying to be a dick here, but Brian is neglecting those pesky 2-3 million years of human history BEFORE bread. That’s part of the problem, when folks start talking about this stuff. If you are oriented in such as way that evolution via natural selection is not at play, if you think 10,000 years ago was “a long time ago” you are lost. Literally, lost. So, if you want to pull out an anthropological anecdote, you had better frame it in a comprehensive way. Do you think we evolved as vegans? Cool, start at the beginning, build your case and include the tools of the trade: optimum foraging strategy, comparative anatomy, molecular biology etc. But if you throw something out that fits none of the observed data (agriculturalists fared poorly compared to HG’s) and the molecular mechanisms…don’t bother.

One final thing: Social networking “surveys” and N=1 performed millions of times.

I was recently approached by Prof. Cordain and one of his graduate students to make a blog post asking for folks who:

  1. have been diagnosed with an autoimmune disease,
  2. ate a paleo diet, and
  3. put the autoimmunity into remission.

Now, this is at BEST a survey. It shows massive selection bias (how many people have tried paleo and NOT resolved autoimmunity?) but it’s interesting in several ways:

  1. The resolution of autoimmunity by removing grains and thus reversing gut health is supported by the molecular mechanism I mentioned above.
  2. No on else (vegans, raw foodists, standard American diet) are reporting resolution of autoimmunity the way the Paleo community is. We are addressing gut health, vit d levels, dysbiosis and stress. All couched from an evolutionary perspective supported by molecular biology.

At the end of Brian’s piece he has the following:

The belief that a gluten-free diet is a good idea anyway has also been studied, and so far the only groups we’ve found that it may actually be somewhat helpful for are patients with Parkinson’s disease, multiple sclerosis, and a few other conditions.

Apparently Brian did not dig very deep as he missed my site, all of the work by Cordain, Lindeberg, Fasano etc. Or he did not do something simple like a google search with a disease like “pancreatitis and gluten” which produced the following:

Rev Esp Enferm Dig. 2008 Dec;100(12):746-51.

[Relapsing acute pancreatitis associated with gluten enteropathy. Clinical, laboratory, and evolutive characteristics in thirty-four patients].

OBJECTIVES: To describe the frequency and the clinical and laboratory characteristics of relapsing acute pancreatitis (AP) associated with gluten enteropathy (GE).

PATIENTS AND METHODS: We prospectively examined all acute pancreatitis cases admitted to our Department in 2006. We recorded a total of 185 patients. With recurring forms, 40 (22%) in all, we used a clinical-lab protocol including serologic and genetic markers, and duodenal biopsy to rule out GE.

RESULTS: A total of 34 patients (18%) met clinical-biological criteria for GE (group1), and were compared to the remaining non-GE AP cases (n=161) (group2). Mean age in the GE group was 54 +/- 25 years, slightly younger than group 2 (61 +/- 14) (NS). There was a mild predominance of women (50%) in group 1 versus group 2 (38.5%) (NS). Seven patients in group 1 (20%) had severe AP, as compared to 27 (17%) in group 2 (NS). The presence of cholelithiasis in group 1 involved 6 cases (18%), which was significantly lower than in group 2–72 cases (45%) (p < 0.05). Four patients with GE developed pseudocysts (12%) versus 13 (8%) in group 2 (NS). Tissue transglutaminase (tTG) was elevated only in 3 patients (9%). Nine patients (34%) were DQ2 (+) and 4 (12%) DQ8 (+); the rest (54%) were all negative for both markers. From an endoscopic perspective there was diffuse duodenitis in 32 patients (95%). Duodenal biopsies revealed villous atrophy (Marsh 3) in 2 patients (6%); submucosal inflammatory infiltration (Marsh 2) in 10 (29.4%); increased intraepithelial lymphocytes (Marsh 1) in 8 cases (23.5%), and normal mucosa (Marsh 0) in 14 patients (41.2%). Response to GFD after 1 year was excellent in 30 patients (88%).

CONCLUSIONS: Relapsing AP with GE represents a relatively common association that is indistinguishable from other APs from a clinical-evolutive standpoint, except for a lower presence of cholelithiasis (p < 0.05). A specific diagnostic protocol is much needed in the identification of these patients since GFD is the only effective therapy to prevent new AP events from developing.

I feel compelled to point out the resources Brian DOES provide for the “gluten is fine” position he seems to be painting. A clinical trial with ambiguous results, and something from Quackwatch. I’ll just bite my tongue on the Quackwatch topic as it just turns into a Straw-man type of scenario. But (and this may be a bit mean) if you are going to label yourself a “skeptic” you had damn well better do some homework.

So Abraham, this is my answer.

It took me all day to put this together, there are 1000 people like Brian posting every day.It feels like a losing battle at times. So, in the future, when someone explains about how a gluten free diet is bogus, if they are literally not worth talking about that is going to be my answer. This piggy-backs on the Neanderthal A Go Go! post. Until something is actually new or important, I’m likely just going to say “I wrote on that” and call it good.

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  1. Mario
    January 12, 2011 at 5:26 am

    Robb,

    A nutricionist here, in Brazil, Fabiola Pires, published last year his master thesis about gluten and obesity. Ok, it was done in rats. But, anyway, rats feed wheat gluten gained 25% more weight than rats that did not eat gluten. And had 33% more abdominal fat. She is now doing her doctorate in this theme.

    http://translate.google.com/translate?js=n&prev=_t&hl=pt-BR&ie=UTF-8&layout=2&eotf=1&sl=pt&tl=en&u=http://www.em.com.br/app/noticia/tecnologia/2010/09/20/interna_tecnologia,180745/gluten-pode-engordar-diz-pesquisa-da-ufmg.shtml

  2. Darren B
    January 12, 2011 at 5:49 am

    OMG Robb that was awesome! I damn near knocked over my entire plate of poached eggs and bacon, and damn you, almost spilled my coffee whilst laughing hysterically;)

    Ty though for taking the time to prepare a post like this though. It is a great resource for us lay folks to use should one of our “not so enlightened” friends were to ever pose such a statement to us.

  3. Adam Kayce
    January 12, 2011 at 6:04 am

    I’m not taking the time to comment because the person talking about gluten/grain intolerance can not even sit down at the table for a chat.

    Thank you! It’s as if people feel they are authorities on nutrition simply because they eat.

    (oh, and re: the font situation – it could be from pasting in code from other sites into the Visual editor, or from MS Word. If you ever have anything in Word, paste it into wordoff.org first; it’ll make it squeaky clean.)

    • Robb Wolf
      January 12, 2011 at 7:17 am

      Thanks Adam, I will tinker with that.

    • Gene
      July 15, 2012 at 11:56 am

      Just keep notepad open. paste into notepad, then select the text and copy/paste to wherever. Ctrl-C/Ctrl-V are handy.

  4. Michael Kvetny
    January 12, 2011 at 6:26 am

    Thank you very much, Robb, for doing the work. I will link to this on my site as I am sure a lot of other people will.

    Wow, you are receiving a lot of flak these days. Mr Comments Off aka. A. Colpo is dissing you greatly on his “blog”: http://anthonycolpo.com/?p=932 above and beyond misspelling your last name. Matt Stone is right now referring to Paleo as an eating disorder, because we just won’t accept “the well-identified health benefits of whole grain consumption”.

    In my thinking, the benefits that are detected in (some) people who switch to whole grains stem from the omission of refined grains as well as the overall bettering of their diet. Overall bettering? Yes. Anybody who is suddenly convinced by “science” that whole grains are healthier will surely try to become healthier in all areas thus confounding the picture.

    BTW, here’s an idea for a t-shirt: No Grains, No Pains.

    • Robb Wolf
      January 12, 2011 at 7:17 am

      Well, must be doing something right ;0)

    • Adam Ball
      January 12, 2011 at 7:45 pm

      Yikes, I can’t imagine how long it took Colpo to write that
      post. It’s a whole lot of nothing. It’s funny to me how people can
      spend 1000′s of words on a post that says “I’m not wrong,
      HE’S/THEY’RE wrong!” I have no idea what it’s called, but he
      essentially puts words in the low-carbish paleo folks mouth and
      then tells them they’re idiots for saying that and trying to
      disprove it. SO odd. I wouldn’t waste your time even visiting their
      sites, Robb (or anyone else, for that matter). Beauty post,
      Robb.

      • Robb Wolf
        January 12, 2011 at 8:23 pm

        Thanks Adam. If they ever want an actual exchange, I’ve laid out my guidelines.

        • Greg Battaglia
          January 12, 2011 at 9:00 pm

          Hey Robb, Colpo was actually attacking your stance on
          cortisol, not gluten issues. Basically he argues that after fat
          adaptation cortisol will still remain elevated on a low-carb diet
          long-term when compared to a high carb diet. He cites some research
          but most of the studies that he cites that actually measure
          cortisol are short-term studies that involve strenuous exercise
          during the fat-adaptation period. I’d be interested to see your
          response to this. Good post btw.

          • Robb Wolf
            January 13, 2011 at 5:08 am

            I think if one is lean and training hard (glycolysis) this is likely spot on…which is why I’ve always recommended aggressive PWO carbs. I guess if Anthony bothered to read what I’ve written he’d know that!

  5. Jim
    January 12, 2011 at 7:51 am

    Robb,

    This is EXACTLY the type of post that attracted me to your site long ago and the type that keeps me coming back. TY for taking the time to compile and explain the relavant research and for making it accessible to the lay person.

    Jim

    • Robb Wolf
      January 12, 2011 at 10:09 am

      Thanks Jim, and my desire with this is to actually have these guys pick it apart, piece by piece. If someone can do that we will be better off because we will better understand what is happening.

      • Mandy
        April 7, 2013 at 5:15 pm

        Robb, in addition to providing us with the cold hard science, you present it in a way that’s interesting and quite hilarious. It turns heavy “science-talk” into something enjoyable. You’re the best :)

  6. Mark__S
    January 12, 2011 at 8:20 am

    Hey Robb! Bet you didn’t know you had so many fans in Brazil! I’m writing you from Curitiba. Lot’s of grass-fed beef down here. I just got your book on Kindle and am on my 3rd day of the Paleo diet.
    I want to say THANK-YOU for taking the time to respond to these so called skeptics that want to denigrate paleo in the eyes of the public by calling it a fad diet etc… People like that make it so much harder for someone with a grain addiction to switch to a healthier way of eating. When one tries to quit smoking or drinking most people are supportive, but try giving up grains and you have most of society shrieking at you that you are nuts and it’s a fad diet.
    Anyways guy… I loved the book and your writing style and thanks for all the hard work you are doing on our part!
    - Mark

    • Robb Wolf
      January 12, 2011 at 10:08 am

      Mark! that is awesome! I LOVE Brasil. I did capoeira for year, still do some BJJ. Portuguese is my favorite language (not very good at it yet). Thank you for the reach-out and kind words! Obrigado!

  7. angela p
    January 12, 2011 at 8:58 am

    Thank you, thank you, thank you, thank you. This field or research is only a hobby for me and not my full time subject so putting together a comprehensive post like this is a life-saver. thank you, thank you, thank you, thank you.

    thank you!

  8. Tom
    January 12, 2011 at 9:04 am

    Awesome work Robb! I saw that the other day and rolled my eyes. Glad you took some time to refute it.

  9. qualia
    January 12, 2011 at 9:06 am

    hi robb, i agree with the dangers of gluten, being sensitive myself. however, i was wondering what your take is on this: http://is.gd/urDIoG
    (seen in the comments of http://heartscanblog.blogspot.com/2011/01/is-einkorn-answer.html )

    what do you think of einkorn, and it’s apparent non-toxicity in vitro and some positive anectotal reports? worth a try? einkorn also seems to have some nutritional advantages like higher carotene, mineral, and amino acids content.

    • Robb Wolf
      January 12, 2011 at 10:06 am

      It is simply less problematic. I;d personally not touch the stuff.

  10. qualia
    January 12, 2011 at 10:17 am

    what are your thoughts on the new state of the art
    cyrexlabs gluten sensitivity tests (especially #3):
    http://cyrexlabs.com/Catalog/tabid/170/Default.aspx many call it a
    breakthrough and paradigm shift. and also this: “Cyrex researchers
    were surprised to find COFFEE has the highest rate of
    cross-reaction with gluten.” !!! wtf?? lol
    http://drknews.com/what-type-of-gluten-intolerance-do-you-have/ do
    you need to give up your 3 remaining espressos a day for good now? ;) but seriously, have you been aware of these x-reactivity issues?
    are they for real? i’m sensitive to almost everything on this
    list!

    • Robb Wolf
      January 12, 2011 at 12:20 pm

      Everyone us sensitive so why fuck around with this! Waste if money.

      • qualia
        January 13, 2011 at 1:02 am

        why? there are at least 4 reasons why such an advanced test
        makes a lot of sense: 1. increases “willingness” of a
        (conventional) doc to prescribe a strictly gluten free diet, 2.
        massively increased compliance of a patient or any person
        interested in disease prevention if there is a lab statement
        showing ACTUAL antibodies to gliadin and/or related molecules. 3.
        detection how far the sensitivity has progressed, or which tissues
        are involved. 4. showing cross reactions to other foods that still
        might be a part of the nutrition and may mask the benefit of a
        gluten free trial phase (a TON of people are clearly sensitive,
        even showing beginning celia, but don’t feel that much better after
        giving up gluten. why? this thest can help. your statement
        “Everyone us sensitive so why fuck around” doesn’t really help much
        in the doctors office.. ;) (at least for the next few
        years)

        • Robb Wolf
          January 13, 2011 at 5:02 am

          The problem I’ve seen is a lack of testing that brackets what we see with an elimination diet. large numbers of false negatives leads to continued consumption and no resolution. I’d need to be convinced the tests work, but if they did I’d have to say you win, it would be worth it…but again, the tests must work, which I’m not confident of. Yet.

          • qualia
            January 13, 2011 at 7:06 am

            true, but if you listen to sean’s latest podcast (http://is.gd/0SXd6p ), interviewing dr. thomas o’bryan about this new lab and the tests (he’s listed as clinical advisor on the lab site btw), you will see that there is reason to be very optimistic about the quality of these new tests. i mean, everyone knows dr. bryan when it comes to gluten – this dude know his stuff.

          • Robb Wolf
            January 13, 2011 at 7:37 am

            I have not listened to it yet, very familiar with Thomas. VERY happy to see how aggressively Sean is tackling the gluten issue.
            Qualia, thanks for pestering me on this topic. I’m just so focussed on the elimination element of this (it works, costs nothing, it works!) that I’ve downplayed the significance legitimate screening might bring to this topic. Please shoot chrissy an email at the contact page and let her know I want to send you a t-shirt (tell her the size).

          • Deanne
            January 15, 2011 at 3:37 pm

            I totally agree with Robb on this testing issue.

            I took my 17 yr old daughter in for stomach issues four years ago. She has been diagnosed with lactose intolerance for many years but funny we could never track all that lactose down enough to eliminate the stomach issues. So new GP orders blood test for Celiac. Never heard of it. She tested positive. These ran I think $350.00 a pop. Meanwhile my daughter is like taking out gluten left and right for relief and I am helping her.

            She is finding relief but we are taking eggs out now and seriously looking at corn. Then we go to gut specialist a few weeks later when we can get in to see him and he orders the same test over cha ching $350.00.

            Then the blood tests come back negative. He now wants her to go back on gluten and then do scope test. No way she says. Then he says we should do another blood test. I ask him will that blood test confirm she has Celiac if not then why do it? These tests are a gravy train for these specialists IMHO. He carefully says no it will not guarantee it. I realize there will be no end to this and that maybe is why it takes like 11 yrs on average for Celiac to get correct diagnosis. Plus a small fortune in testing. Once you go down the Celiac rabbit hole you are a changed person and you can ignore the bigger picture here.

            I go online and so many moms out there are telling all sorts of horror stories regarding testing. Endless online sites and posts. How tests come back negative and it turns out the kids have Celiac. (This year Italian researcher confirms you can get it later in life).

            What I pulled from these endless stories is…if you feel better without gluten, take it out. Real simple.

            The tests are poor, faulty and not there yet. Many times with Celiac they say milk is problem because it is tough protein to digest. Four years ago I was able to google very little on villi, atrophy, milk except for these researcher in UK decades ago (1970′s) how they found that milk can cause villi atrophy!

            I wondered if eggs can cause it. Tried to research that and FDA says no way for chickens who eat grain to pass it on but no real studies to cite. It is impossible they said. But no one had actually tested it.

            Now I google villi, atrophy, milk and tons of stuff pulls up. It is mind boggling. The launch sequence has begun and there is no way of putting the genie back into the bottle now.

            Big agri doesn’t seem to be funding this but they are funding WSU to come up with gluten free wheat. They certainly see the hand writing on the wall.

            When they tell you to do the elimination diet then you know they haven’t the means or tests to do it. Even they are down to if you feel better without ____ then leave it out.

            Just as everything in life there is gradations, not much is black and white. Celiac are hyper sensitive and react strongly or not as strongly and I think for many who do not test positive maybe our immune system’s are not destroying villi but freaked out and going postal on our muscles in MS or all the other autoimmune ways of acting out.

            I think autoimmune terminology diverts attention to the fact certain foods are toxic to humans and puts blame in a way on the patient as having a medical condition and is unusually hyper sensitive.

            I think many Universities are funded/encouraged by big food and pharmaceutical giants to create new names for food toxicity reactions and design a pill for it instead. Restless leg syndrome seems to be the newest one.

            I haven’t had a need for antacids after going Paleo and I was using them for decades.

            Celiac has been on the back burner way too long in the U.S. and why is that? It is a scary thought for big food. Other than anti rejection drugs to tap down your immune system so you can eat toxic foods it is much easier to have restless leg syndrome.

            The tests aren’t there, because the money is not there. The money is not there because the support is not there. The support is not there because big food and big pharm would lose money on this initially but hey I don’t need to see all those specialists too. A lot of revenue is at stake here. In my humble opinion/rant.

  11. Diane @ Balanced Bites
    January 12, 2011 at 10:48 am

    If there’s been one thing I’ve agreed with you on 100%
    since the first time I sat through your seminar it was that if
    people just went gluten-free it would be life-changing and
    life-saving for them, regardless of any other dietary/”Paleo”
    changes they may or may not make. I’m working on a post or possibly
    a series about how gluten is killing my family, and everyone else’s
    too, but it’ll be a little bit before I get it up on the blog!
    Hopefully my voice can speak to some of the skeptical laypeople
    while yours speaks to the scientific-skeptics out there. Thanks for
    all that you do with your head and your heart.

  12. Katie
    January 12, 2011 at 11:22 am

    Thanks for posting this! I have also gotten so frustrated
    with negative comments about eating paleo/gluten free that have no
    scientific backing and stem from personal opinion or common
    perception. I get comments all the time about a high fat, paleo
    type diet being bad because “you aren’t getting enough fiber” or
    “grains have so many good nutrients,” or “all that fat will give
    you heart disease and diabetes.” (diabetes… really?) There is no
    science to back this up (not to mention other foods that have
    better fiber and nutrients: hello vegetables and meat!). It is
    amazing to me sometimes that despite my own results and test
    numbers that show that this way of life is obviously more healthy,
    and the many success stories from others, we still see such
    comments of those who not only disagree, but think we have an
    “eating disorder!” thanks for all the detail in your post and for
    the great info. I think in the future, I may adopt a similar policy
    of not debating a topic if the other person can’t back his/her
    opinion with basic science!

  13. Jamie
    January 12, 2011 at 12:11 pm

    You might be interested in this unpublished pilot study
    from Australia Robb. I can email it to you so you can get the table
    if you like, just let me know. GLUTEN AS A CAUSE OF
    GASTROINTESTINAL SYMPTOMS IN PATIENTS WHO DO NOT HAVE COELIAC
    DISEASE Biesiekierski JR, Newnham E, Irving P, Barrett JS, Haines
    M, Doecke J, Shepherd SJ, Muir JG, Gibson PR. Dept. Medicine, Box
    Hill Hospital, VIC Despite increased prescription of a gluten-free
    diet (GFD) as a treatment for functional gastrointestinal (GI)
    symptoms in those who do not have coeliac disease, there is minimal
    evidence that gluten is a trigger. Aims: To determine whether
    gluten ingestion can induce symptoms in non-coeliac individuals and
    to examine the mechanism. Methods: A double-blinded, randomised,
    placebo-controlled rechallenge trial was undertaken in patients
    with IBS in who coeliac disease was excluded (histology or gene
    typing) and who were symptomatically controlled on a GFD.
    Participants received gluten or placebo as two bread slices plus
    one muffin per day together with a GFD for 6 weeks. Symptoms were
    evaluated by a visual analogue scale and markers of intestinal
    inflammation/injury and immune activation were monitored. Results:
    34 eligible patients (29-59 y, 4 men) were randomised. 56% had
    HLA-DQ2 and/or DQ8. Adherence to GFD and supplements was 100%. The
    mean (SEM) of change of symptoms (mm) after 1 week of therapy are
    shown in the Table. Using a longitudinal model, the severity scores
    of pain (p=0.012), satisfaction with stool consistency (p=0.016)
    and tiredness (p=0.002) were higher for those consuming the gluten
    (repeated measures ANOVA). Anti-gliadin antibodies were not
    induced. There were no changes in faecal lactoferrin,
    ultrasensitive CRP or intestinal permeability. There were no
    differences in any end-point in those with and without DQ2/DQ8.
    Conclusions: ‘Non-coeliac gluten-intolerance’ does exist, but no
    clues to the mechanism were elucidated. Clarification of the
    phenotype of such patients, the mechanisms by which gluten induce
    symptoms and clinical significance is required.

  14. Mike
    January 12, 2011 at 1:34 pm

    Robb, I love the science that you have up there. I’m glad
    there’s someone like you to verify all of the ultra scientific (to
    the lay man) info and relay it to us. What I don’t understand about
    people who are refuting the validity of a paleo diet is how they
    can ignore the facts. I’m talking about the results. In simple
    terms everyone I know who has gone paleo has experienced 1.
    Improved body composition (I’ve gained muscle while dropping 43 lbs
    on the scale!) 2. A steady level of energy 3. Decrease in
    inflammation 4. improved health How can people ignore the
    obvious?

    • Robb Wolf
      January 12, 2011 at 8:30 pm

      Mike- I dunno. Especially when the hard sell is “try it, let us know what happens.”

      Kinda sad, but what can you do?

      • Brian
        January 13, 2011 at 8:13 am

        Hey Robb,

        I think that the skeptical community uses a heuristic of sorts for medical stuff–if it isn’t conventional wisdom within the mainstream medical community, it must be quackery, so dig around for some evidence to prove it is bunk. That seems to be what Dunning was going for here.

        Skeptics apply this to low-carb diets, paleo and all sorts of things. For instance, I have been frustrated when trying to defend a low-carb approach to fat loss. One prominent skeptic accused me of special pleading when I suggested that current trials testing low-carb diets were not sufficiently controlled to disprove the hypothesis. Of course, when I mentioned that it worked for me, I was reminded that anecdotes are not helpful and N=1. Hell.

        One more thing is at work here. Unfortunately, the “try it and see if it works” message definitely sets off alarm bells in the skeptical community. Much of the commentary on Dunning’s site reflects this. A person can say the same thing about all sorts of rubbish–Acai berries, electromagnetic bracelets, crystal healing, Tibetan bat guano, Tahitian Noni juice–whatever. Anything that is supposed to provide a miraculous cure has been sold in this way. Saying “try it and see” is an official red flag for quackery among skeptics.

        The problem with “just try it” is that it is subject to all sorts of subjective “effects.” Confirmation bias, spontaneous resolution of symptoms, placebo effect–all of these can make someone think that something is working when it really isn’t doing anything.

        The obvious difference as I see it is that you are advocating OBJECTIVE measurements to confirm the effectiveness of a paleo diet rather than purely subjective ones like “I felt better.” Do you lean out? Do you lift heavier? Stuff like that. Unfortunately this seems to be a point that the skeptics I have spoken with are unwilling to concede.

        • Robb Wolf
          January 15, 2011 at 5:01 am

          Great points. I do think we have the added level of
          bookstore tracking. So we have both subjective and objective data
          points

  15. Gail
    January 12, 2011 at 3:16 pm

    Robb Thanks so much for this great post. I had only
    recently started listening to the Skeptoid podcast but after
    listening to this unscientific, poorly researched, self-righteous
    episode I unsubscribed immediately. I just couldn’t trust anything
    Brian Dunning had to say after this. Love your work.

    • Robb Wolf
      January 12, 2011 at 8:28 pm

      Well, he may do ok with Bermuda Triangle type stuff buy he stepped seriously outside his pay-grade I tackling a complex molecular biology topic with an afternoon worth of research.

  16. Jamie
    January 12, 2011 at 3:43 pm

    A good resource page here:
    http://www.greenmedinfo.com/page/wheat-gluten-research And these
    are must read articles for anyone with an interest in this area
    (send to your sceptic friends and watch their heads implode)…
    http://www.greenmedinfo.com/page/dark-side-wheat-new-perspectives-celiac-disease-wheat-intolerance-sayer-ji
    http://www.greenmedinfo.com/content/opening-pandoras-bread-box-critical-role-wheat-lectin-human-disease

  17. 5 FRIES
    January 12, 2011 at 6:11 pm

    That is an awesome, passionate, well put together post. You
    were clearly steaming from the ears while putting it together. For
    some reason the term “molecular baked goods” kept running through
    my head while reading this. I wonder how far you could skip a
    molecular baked good across a glassy pond??? BTW thanks for
    answering my Roy Nelson question on your podcast. It is clearly
    because it was my question, and I had specific interest in it, but
    man was that an awesome, well thought out, professional and concise
    answer. For my money the best of the podcast series(again a biased
    opinion) You really are at the top of your game.

  18. 5 FRIES
    January 12, 2011 at 8:57 pm

    Ha! I can tell by your typos you are still spun up! Good
    luck sleeping tonight and keep fighting the good fight!!

    • Robb Wolf
      January 13, 2011 at 5:09 am

      No, that’s doing this on an iPhone running from flight to flight!

  19. Hone
    January 12, 2011 at 11:47 pm

    Thanks for following up on this Robb. I only eat limited
    grains now days. Had some today as a matter of fact and can feel
    some bloating and irritation in the gut.

  20. Stephen
    January 13, 2011 at 4:24 am

    Awesome post Robb; A definite bookmark and something I can
    forward to the wife to back up my nutrition claims (she’s a
    clinical physicist and vegemetarian (;)) so unless I can back
    things up with peer reviewed journals she’s not on board). My “hard
    sell” isn’t even to try full paleo – I just tell people to cut the
    grains and gluten containing products and see how they feel. Not
    one (N=7 to date) has reported anything less than a greater feeling
    of wellness and the weight loss seen by most is nothing short of
    incredible to them. OK, so it’s a small sample size but the results
    are enough to convince them that something is right and they spread
    the word to their friends and family. The movement is definitely
    growing and eventually I hope will become so huge that the
    “mainstream” has to take notice, naysayers be damned. Thanks for
    all you do. Keep up the great work.

  21. Penny
    January 13, 2011 at 6:10 am

    Thanks for that top shelf post, Robb. I don’t pretend to grasp half of it but the attitude that this is the science; show me otherwise, is an attitude I respect.

    My older brother was skeptical and a bit concerned about my paleo jabber, and I didn’t argue. Three months in he can see for himself what it’s done for me and nothing else would have convinced him, so I’m glad I saved myself the trouble!

    Thanks also for the forum…it rocks!

  22. Bill
    January 13, 2011 at 8:51 am

    I saw that a while ago, tried to bring in another viewpoint, but was immediately shut down by all the amateur scientists. I will admit, I have a very limited grasp of scientific method, mechanisms, and reasonings, yet I knew that the article couldn’t hold it’s own. It got me thinking how, I really love science and technology and everything it’s given us and explained, but people seem to get caught up in it at times, refusing to believe something is possible until it’s scientifically proven. They forget that science always follows observation; some idiot has to try something before we know it’s possible. Thanks for being that idiot and getting me to join you, Robb. Someday they will make statues in your likeness.

    Unless someone like Dr. Oz or Oprah comes along first and takes credit for starting these anti-gluten shenanigans, than you’ll probably just get a plaque.

  23. Matt Lentzner
    January 13, 2011 at 12:07 pm

    I finally got around to reading the skeptoid post and boy was I disappointed. The writing and logic is so half-assed it’s comical. Referencing conventional wisdom is not science, and he’s got his facts wrong as well. Ignorance is not the same as skepticism!

    I read a post by this guy on low-sugar diets, and it was just as lazy. I decided he wasn’t worth my time. This new item just stars and double underlines that sentiment.

  24. Matt Lentzner
    January 13, 2011 at 12:27 pm

    Sorry to post again, but I’m all wound up now. :)

    Let’s just say for the sake of argument that only 10% of people have a significant problem with gluten. (My belief is that it is much higher than this, but I am being conservative) Does that mean that it’s not worth the trouble to try a gluten-free diet since the chances are relatively low?

    It’s absolutely worth it.

    Would you give up gluten for one month if you were given a 10% chance to win $100,000 at the end of that month? $100,000 isn’t even close to the cost of living with a gluten issue. The lost productivity, the low quality of life, the medical care required, the shortened lifespan, the disability, it isn’t even close.

    Considering the risk/reward calculation it seems like a “no-brainer” to me.

  25. Nancy
    January 13, 2011 at 3:54 pm

    wow, way too technical for me, Robb, but good way to get the point across. I just know I feel better, have way better lab results. That’s a good enough argument for me.

  26. Brian Dunning
    January 13, 2011 at 4:01 pm

    Although we’d all like to believe that perfect health is as simple as a miracle diet plan — as Robb Wolf says on this page “Lose fat. Look younger. Feel great. Avoid cancer, diabetes, heart disease, Parkinson’s, and Alzheimers” — the fact is that anyone selling such miracles is, well, trying to sell you something.

    Although he’s thrown enough sciencey-sounding technobabble at you to make even Deepak Chopra choke, you will likely find very few health professionals who agree that special diets can indeed bring you miracle health. Rather than throw money at the first salesman who can put impressive-sounding science words into a blog post, instead do your own research on reputable non-sales web sites, like WedMD or even Wikipedia, or talk to your doctor.

    A paleo diet is perfectly fine and will not hurt anyone, and is probably as healthy as any normal balanced diet. Please don’t expect it to be some incredible secret miracle. Be very skeptical of anyone who makes the spectacular claims you see at the top of this web page.

    • Penny
      January 14, 2011 at 7:20 am

      Hi Brian…it has been a miracle for me. I am a skeptic after 30 years of doctoring for unexplained trunk rashes, toxic thyroid nodule, arthritis and fatigue. My doc just shakes his head and tells me to keep doing whatever it is I’m doing. I think it’s going to take a long time for our medical profession to really grasp this, but the proof is in the pudding. I’ve been able to discontinue celebrex and my husband has been able to discontinue statins.

    • Brian Day
      January 14, 2011 at 8:19 am

      Mr. Dunning,

      You keep making statements to the effect that Robb is trying to sell people something. I don’t get it. What is Robb trying to sell? He has a free podcast. So do you. He has a website and blog where he includes show notes and links to source material. So do you. He has a book. You have three. Anything people can buy from Robb he gives away for free.

      As for the spectacular claims, they represent several emerging threads in research within evolutionary nutrition and medical physiology. In particular they reflect current research into inflammatory pathways and their potential links to heart disease, dementia and some cancers. For instance, there is a small but growing group of physicians and researchers who speculate that inflammation may have a greater role in the formation of arterial plagues that blood lipids do. There is also growing evidence that a paleolithic approach can have a significant impact in reversing metabolic syndrome and Type II diabetes (Robb referenced one such study in his rebuttal to your podcast). It is emerging science. Not all of it is right. It is outside of the mainstream, but it certainly isn’t snake oil. Robb’s “spectacular claims” are just a shorthand way of saying “an evolutionary approach to diet is an effective way to combat the diseases of civilization.”

      As I mentioned above, you seem to be employing a heuristic–’if it isn’t conventional wisdom in the medical community, it must be wrong.’ Your arguments are on the verge of being a plea to authority.

      I think you confusing emerging science with pseudoscience. And since when is something “sciency-sounding technobabble” simply because you don’t have the the background to understand it? As far as I can tell, the “technobabble” in Robb’s post took the form of excerpts from published journal papers (for which he provided links). Robb’s commentary was largely for clarification.

      Here are a few Wikipedia links to help you with the technobabble:

      http://en.wikipedia.org/wiki/TLR_4

      http://en.wikipedia.org/wiki/Free_fatty_acid_receptor

      http://en.wikipedia.org/wiki/NOD1

      http://en.wikipedia.org/wiki/CXCR3

      http://en.wikipedia.org/wiki/Zonulin

      http://en.wikipedia.org/wiki/Transglutaminase

      A PubMed search of the above terms might also be helpful. You may want to include such keywords as “inflammation, cancer, heart disease, diabetes, metabolic syndrome, parkinson’s disease, alzheimers and dementia.”

      Typically I enjoy your work on Skeptiod, but I think you have gone off half-cocked on this one, particularly in your ad hominem insinuations about Robb’s motivations and character.

      To paraphrase one well-known skeptic’s tag line:

      “Whenever someone tries to dismiss emerging scientific research with a plea to authority, you should BE SKEPTICAL.”

      • Amber Karnes
        January 14, 2011 at 11:33 am

        Robb’s “spectacular claims” are just a shorthand way of saying “an evolutionary approach to diet is an effective way to combat the diseases of civilization.”

        Blame it on me, the web/PR/marketing person! I thought it sounded more accessible to newbies hitting the site than science geek speak. Haha

      • Chris Lindsay
        January 14, 2011 at 3:31 pm

        Brian Day wrote: “You keep making statements to the effect that Robb is trying to sell people something. I don’t get it.”

        I think Brian was referring to this in the “About Robb” section of his website: “and co-owner of Paleo Brands Inc. a paleo food company selling meals and snacks featuring grass fed meat, wild caught fish and all organic ingredients.”

        I’ve not researched this website, but I’ve read some literature on the Paleo Diet (via HealthyFellow.com), and it seems like a plausible diet option for those looking to shed weight and feel healthier. I also know that studies seem to indicate reduced caloric intake may lead to longer lives (although, I would say that the evidence is at the “interesting” level).

        I would like to see some double-blind, placebo-controlled studies before I accept that it can help with auto-immune diseases (or other). I didn’t see anything in PubMed, is there some peer-reviewed journals that these studies have been done?

        As an aside, the problem with proponents of diets/nutrition/health that are either fringe or cutting edge, is that the few reasonable people get drowned out by the quacks and cranks who believe in alt-med woo. And let’s be honest, there’s a lot of them (Kevin Trudeau comes to mind).

        So it’s good to be skeptical of people making claims regarding health and well-being, because there are a lot of people who are looking to scam those who aren’t aware of their own biases, gullibility, or lack of good judgement.

        • Brian Day
          January 14, 2011 at 4:29 pm

          Hi Chris,

          Thanks for the reply. And I had plum forgotten about the Paleo Brands. I suppose that counts as a product to sell. It really isn’t a big part of what Robb does. But, point taken.

          I consider myself to be a Skeptic. And your thoughts about diets and health are right on. There are a lot of scammers out there. Alternative Health Care is full of them.

          Point here is that Paleo nutrition is a legit field. It has a solid grounding in science. There is plenty of research and healthy disagreement out there within the community. A gluten-free approach is part of the program based on both anthropology and current scientific research like that that Robb quoted in his blog entry. Robb isn’t the only one out there pushing Paleo. It doesn’t cost anything to play.

    • 5 FRIES
      January 14, 2011 at 9:26 am

      Here is the funny thing about what you say. You obviously know nothing about Robb Wolf. When Robb was with crossfit he had an opportunity to retire young. If he had made a supplement line with pre/post workout shakes, and any other snake oil you could drum up to improve performance it would have been worth millions. Reebok would be knocking down his door to over pay for his supplement line. They would kill to have the Wolf Shake.

      Guess what? He didn’t do it All he sold is seminars and his book. All of which took a lot more blood, sweat and tears to produce than a supplement line, and I’m guessing at a fracture of the monetary value of a supplement line. Hell, Robb promotes products he doesn’t even have advertised on his highly visible blog.

      And saying to look to sites like Wikipedia? I like Wikipedia and have spent some time there, but it can not be trusted. My brother was listed as a member of Modest Mouse on Wikipedia for years. He was not a member of that band. Guess who inserted him into Wikipedia? My sneaky brother himself. He might even still be listed, I haven’t looked for a long time.

      I bet Wikipedia and WebMD produce bigger revenue than robbwolf.com. I respect your skepticism, but if your going to call someone out you better come prepared. Actually, as I think about it, I don’t respect your skepticism at all.

      • Amber Karnes
        January 14, 2011 at 11:35 am

        5 FRIES do you think it’s too late to patent the Wolf Shake? Has a nice ring to it… call me, we’ll talk. I won’t tell Robb. Someone should get rich off the Wolf Shake, for real.

        • 5 Fries
          January 14, 2011 at 12:44 pm

          Amber I’m in. I mentioned it to Robb before. Something along the lines of telling new crossfiters if they drink three Wolf Shakes a day they can cut their Fran time in half after only six months. Then let the novice effect take over.

          It would have spread like wild fire when Robb was “in” he just had too much integrity to sell it. I don’t have that much integrity and would love to get rich selling whey powder for $40 or $50 a pound. We’ll be on vaction the rest of our lives!

          I think to be a healthy skeptic one has to look at what somebody is not selling, just as much at what they are selling. Here’s to our easy money.

          • Amber Karnes
            January 14, 2011 at 4:41 pm

            “Just drink a Wolf Shake for breakfast, one for lunch, and have a sensible dinner! You can even have five fries and dessert!”

            Let’s do this.

    • Virg
      January 14, 2011 at 12:46 pm

      Brian –

      The biggest problem that I see with this statement:

      “Lose fat. Look younger. Feel great. Avoid cancer, diabetes, heart disease, Parkinson’s, and Alzheimers” — the fact is that anyone selling such miracles is, well, trying to sell you something”

      …is this: Anyone can “try paleo” without buying anything. So … ?

      Sure, it’s easier if you buy a book/DVD/whatever, since you’ll get more concrete information to go on, but (let’s face it) – you can get by pretty well just on the free information available here. The tenets are fairly straight-forward, in fact. You should be able to “try before you buy” pretty easily.

      “sciencey-sounding technobabble” ?? Seriously? Why don’t you take a printout of that “sciencey-sounding technobabble” and hand it to someone who understands what it’s saying … and ask for their opionion!? Ask nicely, and you might just learn something.

      Ok, sorry – I just couldn’t help myself. Feel free to use your godly moderator powers to refrain from posting my response. I’ll understand, I just needed to say it :)

    • Robb Wolf
      January 14, 2011 at 4:31 pm

      Brian-
      I like that you tweeted “this will not be ok’d at RW.com.” And then, it was. I also like that you addressed NOT ONE of the issues I raised, but instead started the descent into the straw-man attack mode, and compare me to a new-age crack-pot to boot. This is about as thorough as your original treatment of the gluten free topic. You stepped outside your pay grade, got hammered and lack the character to either learn or actually mount a response worth lining a bird-cage with.

      You will never be banned/censored here here because you dig a deeper trench for yourself than I ever could.

      Paleo Tyro-
      Ask your mom to show me 1 study showing protein intake causes kidney damage. It CAN exacerbate preexisting kidney damage, but advanced glycation end-products (from high blood glucose levels) DOES cause kidney damage.

      Cordain thoroughly covered this in the Protein Debate:
      http://www.cathletics.com/articles/article.php?articleID=50

      • Paleo tyro
        January 15, 2011 at 8:49 am

        Thanks for the link! I’ll definitely give it a read and pass it on to my mom. I’ve been asking her the same thing. If it’s in her textbooks they should have references as well.

        How would you measure kidney and liver damage anyway that’s inflicted from a high protein diet.

        P.S. I’m gonna miss this blog having 8 followers and your being able to answer most questions directly!

        • Robb Wolf
          January 15, 2011 at 12:30 pm

          Well, it does not cause it, so tough to measure! They look at GFR, creatinine and some other goodies.

    • julianne
      January 14, 2011 at 5:46 pm

      I changed from a normal healthy balanced diet to paleo eating and got near miraculous results. However as a nutritionist, I thought it prudent to see how it would affect other people before trying to push this as a new improved way to eat. At my own cost and time, I gathered about 25 people from my email client contacts who volunteered to try it out for 6 weeks. Each person organised before and after blood tests, measurements, food diaries, blood pressure etc. All were people interested in health and were eating a relatively healthy standard diet, prior to this 6 week trial.
      75 % of them RAVED about their results, especially health improvements that at the end of 6 weeks, plus they also got improved blood results, lowered blood pressure, fat loss, … The other 25% also had good results, and definite improvements in health and body fat loss.

      Like Robb says – try it for 30 days.

    • Adam Ball
      January 14, 2011 at 7:57 pm

      Hi Brian,

      WebMD and Wikipedia are sources of a large variety of information, but a reliable review of the literature? Not even close.

      While I (and I’m sure everyone else reading your comment) can agree that when someone makes big claims it can bring up some mental red flags, what Robb is “selling” is what *should* be common sense, and as you may have noticed, has also been explained/re-hashed from many different angles (Sisson, DeVany, Cordain, Taubes, even Sears [if you follow the diet with "favourable" carbs]). There’s no “magic pill” and there isn’t even a “magic ratio” to sell. Just the biology/biochemistry of why grains, legumes and dairy are sub-optimal dietary choices that can lead to a wide variety of health problems.

      I’m a health professional. Most MDs have had about an HOUR of nutritional education throughout their education. This isn’t a knock to MDs. They have to learn an unbelievably large volume of information. What I am saying, is that they are not the “experts” on this topic. That needs to be acknowledged.

      Anyway, thanks for commenting. Something we can all agree on is that folks shouldn’t expect a “quick fix” from any one thing, and that educating yourself on a matter is important before undertaking it (especially when it comes to your health).

      Cheers,
      Dr. Adam Ball
      DC MScACN BHSc

    • John Amore
      January 15, 2011 at 10:14 pm

      GTFO you troll.

  27. Lookiehereu
    January 13, 2011 at 4:34 pm

    Where’s Brian Dunning’s response? Why don’t you post that?

    • Amber Karnes
      January 14, 2011 at 6:06 am

      All comments are moderated and Robb is traveling. I just pushed about 30 comments through. Patience, young grasshopper!

      • Ryan Tyler
        January 18, 2011 at 1:43 pm

        did this post ever get approved? i’m dying of suspense. thanks

      • Ryan Tyler
        January 18, 2011 at 1:45 pm

        oh sorry. i think he was referring to the post that is already up. i thought he might have replied to robb saying “just refute one point” i’m paraphrasing. i would love it if he tried to. refute one point that is

  28. Squatchy
    January 13, 2011 at 10:24 pm

    Great post. I applaud you for wanting people to actually dig into this stuff and pick it apart, which as you said, could lead to a better understanding of it all for everyone.
    Now I’m hearing that auto-immune diseases combined were the 3rd leading cause of death last year. It’s almost like all this stuff actually makes sense, haha :)

    Grains are so ingrained into today’s world that’s its hard for people to initially wrap their heads around them being unhealthy. They’re recommended by so many, nutritionists, doctors, even the government. A lot of people will hold onto any notion, or grasp at any straw that may lead them to believe its ok to still eat grains/bread/etc. You can show some people evidence from studies, personal results, results of others, etc, and then they see a nutritionist or doctor recommend eating whole grains on tv or somewhere and they focus on that because it’s what they want to hear. Grains are addictive. I’m glad all this paleo stuff has caught on as much as it has. Looking back at the beginning and how far all this stuff has come, it’s amazing really.

    • John
      January 14, 2011 at 11:47 am

      Brian,

      I’m seriously doubting you even read or can begin to comprehend Robb’s article here. Can you confirm?

      Here’s the gig though… science aside, try it out for 30 days. If you don’t look, feel, perform better, well than it wasn’t meant to be. The fact is though, thousands of people have done this and are confident in its efficacy. You make several other points that aren’t even worth arguing, so I’ll leave it at that.

  29. Brett_nyc
    January 14, 2011 at 8:14 am

    Hey Robb, I think I need a few days to digest this post. :)

    fyi, My wife Cathy and I attended one of your Paleo seminars in Montclair NJ last year. Just wanted to report that with continued Paleo eating, she’s now completely off of her preventative migraine meds.

    keep fighting the good fight.

  30. kem johnson
    January 14, 2011 at 10:52 am

    Rob, you are wasting time responding to Dunning. He isn’t worth the time or effort. He has a reputation for chery picking the wrong facts and running with them.

    I stopped listening to Dunning (it didn’t take long) in the beginning of a post on organic agriculture. I know a reasonable amount about the subject… that’s what we do on our farm. I was appalled at his ignorance and his arrogance. In his opening lines he poisoned the well for me with is ad homs towards organic farmers.

    Brian Dunning is curently getting a roasting at the SGU forum for being stupid with the facts regards to the banning of DDT.

  31. angela
    January 14, 2011 at 11:09 am

    “non-sales websites as Web MD and Wikipedia” Are you kidding me? I actually laughed out loud. I guess Pubmed has been commercialized since last I looked. As one of those healthcare professionals (and coincidently a scientist) I happen to agree with the science behind Paleo. Wow, what an insult.

  32. BP
    January 14, 2011 at 11:45 am

    I love the post and it offers a chance to throw down some great info but why respond to a cook fringe? Why even give this guy the time of day? Can’t tell you what to do but this guy is a conspiracy guy and happens to talk Paleo. I am sure this is giving him more traffic than he has gotten in a long time. This reminds me of the whole Crossfit Radio show with Mike Boyle thing but at least Mike Boyle is a well known S&C guy. Now if Paleo is blasted by someone who people think is credible that is one thing, be great to respond to something like that.
    In the link economy I just don’t like giving people pub who do not deserve it.

    Great info though, so it is good you got fired up. Keep the great work coming. My wife and I totally dig Paleo. We have seen lost inches, better health, and better performance.

  33. Paleo tyro
    January 14, 2011 at 1:12 pm

    Hey Robb, paleo noob here. My mom is on the fence with this diet. She’s a dialysis nurse and it’s been generally hammered into her head that too much protein and fat in one’s diet overworks the kidneys and liver (Which is of course true). So, do you know the precise numbers– what’s too much protein, 2+g per pound?– and the studies that these conclusions were drawn from?

    From my very simple understanding, because fat is a natural appetite suppressant and that starchy diets interfere with the brains response to lectins (Whose role is to tell the brain that the stomach is full, and to place fat in places where its supposed to go and NOT supposed to go( i.e. the liver) participants on the paleo diet in studies seem to naturally eat less. 400-500 calories less in the ones that I read. So the liver and kidneys might not be overworked despite eating mostly fat and protein. Also, low carb diets seem to burn more excess liver fat than low calorie diets, or the Mediterranean diet, so the liver is in better shape than your typical liver on your typical starch rich diet.

    Last edit: 2011-01-15 04:32:38

  34. Martin Frigaard
    January 14, 2011 at 2:17 pm

    From Jonsson et al.
    “A prospective observational study on intake of refined grains as part of a “western diet” pattern showed a positive association with increased risk for type 2 diabetes [93]. Although the foods with major contributions to the “western diet” pattern were all positively associated with increased risk for type 2 diabetes, the consumption of refined grains remained significantly associated with the risk for type 2 diabetes when the foods with major contributions were modelled simultaneously [93]. However, the same study also showed a reduced risk for type 2 diabetes with a high intake of whole grain as part of a “prudent” diet pattern [93], and whole grains are reportedly also inversely related to weight gain, even after multivariate analysis for several indicators of a healthy living such as non-smoking and physical activity [94]. Accordingly, there are contradictory results from studies on effects of cereal grains on diseases of affluence. If not due to confounding factors, this is possibly explained by beneficial effects of whole grains as compared to refined grains, including higher fiber and micronutrient content, coupled with the usually inverse relationship between intake of whole and refined grain [94].”
    From same author, Human trials.
    “Conclusions/interpretation: A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.”

    Effect size calculation would be helpful to interpret meaningfulness of findings due to the small sample size in this experiment (n = 29)(these are usually done for a meta-analysis, but the calculation is simple enough. Effect size = Mean(group1) – Mean(group2)/ S(pooled) for the two groups. Or follow this ppt for a great understanding of this mason.gmu.edu/~dwilsonb/downloads/effect_sizes.ppt.)

    Other main points from this article.
    “During the 12 week dietary intervention, both groups decreased their waist circumference with a greater decrease in the Palaeolithic group (p=0.03; Table 2). Weight loss was on average 4.4 kg with no significant group difference.”
    “It is conceivable, but not very likely, that the more pronounced improvement of glucose tolerance in the Palaeolithic group was due to higher motivation (rather than different food patterns). We were meticulous in our efforts not to give the subjects in the Consensus group a feeling of belonging to a control group. Thus, we told eligible persons that we were to compare two healthy diets, not knowing which was the better one. We informed all subjects individually of the presumed benefits of their respective diet (but not of those of the other diet) during two 1 h sessions, and all subjects were provided with recipes and written dietary advice of equal length. During the 12 week trial, waist circumference decreased more in the Palaeolithic group, but this did not explain the more pronounced decrease in fasting and post-prandial plasma glucose in these subjects.”
    From the article the “Spanish Journal of Digestive Disease”, it seems like more of a methods paper than a findings paper? “A specific diagnostic protocol is much needed in the identification of these patients since GFD is the only effective therapy to prevent new AP events from developing.”
    And the online survey with Dr. Cordain would have “massive selection bias (how many people have tried paleo and NOT resolved autoimmunity?)” …and use the internet regularly, blog, read your blog, etc.
    I have no idea who Brian Dunning is. I can only assume he is another blogger. I posted earlier a video from Michael Shermer, owner of Skeptic magazine, and writer for Scientific American. In this video he talks about useful tools in helping identify “baloney”, a method he credits to Carl Sagan. I recommend EVERYONE watch it. It is useful in everyday life, not just in science.
    Robb,
    I would never disagree with you about diet practices, gluten intolerance, etc. I agree with your statement of “an evolutionary approach to diet” because I think there should be an evolutionary approach to everything.
    I do think you owe your readers, and the authors of these articles you have used to help demonstrate your point, the FULL credit of their findings. Having done a number of literature reviews, (and as I am sure you remember from YOUR literature review) I can say 3 articles on a topic is interesting, but hardly a theoretical framework.
    I always enjoy reading your site. Hope to catch up soon.
    Martin

  35. Jon
    January 14, 2011 at 4:32 pm

    I also find it funny how Brian accuses Robb of trying to prophet off paleo. Looking at his site he has ads for the very things he dismisses so he can make money. To not sound like a hypocrit he places BS disclaimer above the ads. The dude is lame.

    • Jon
      January 14, 2011 at 4:33 pm

      and forgive my mispelling

      • Chris Lindsay
        January 14, 2011 at 10:16 pm

        Maybe you can provide some examples, because I don’t see any ads endorsing pseudoscience on his website (skeptoid.com, right?).

        I will say, there are some science blogs that do get google ads which promote something that the bloggers criticize (scienceblogs is notorious for this, for example), but that’s not the bloggers fault. That’s likely whoever owns the domain or paying for the host site.

        For example, I’ve seen ads for evangelical topics on PZ Myers’ Pharyngula, and ads for pharmaceutical drugs on Mike Adams’ Natural News. In both instances, it likely drives them crazy. The advertising cuts both ways. I think it’s funny, but obviously not intentional.

  36. Lookiehereu
    January 14, 2011 at 7:48 pm

    Are you all blind? OF COURSE Robb is making money off of claims about gluten diets – his food products, books, it’s all a sell-job for the false ideology behind the product lines. The “sciencey-sounding” stuff that Brian points out is pretty accurate, it’s just a bunch of BS that reads like some kind of “proof” but the reality is that none of you actually understand any of it, because if you did, you’d see that it amounts to pretty much nothing more than animal studies and very limited sample sizes. It’s very weak “proof” and nowhere near the extraordinary proof that’s required to support these extraordinary claims.

    Finally, any scientist that pimps himself as much as this Robb guy should NEVER be trusted. True, reputable, trustworthy scientists pimp the science – not themselves. You’re being fooled by a charlatan – a con-man, a really good one too.

    Accept the possibility that you might be getting played before you spend any money on this BS.

    • Andrew Lathrop
      January 15, 2011 at 4:20 am

      Shut your pie hole, you! Troll all you want, that’s easy.
      Want to live a REAL experience, away from your computer? Knock off
      grains, dairy and legumes for 30 days. Do it. THEN come back and
      tell us what you think. Its all in the doing, dude. Step up if you
      are interested in living a better life.

  37. Superdeluxe
    January 14, 2011 at 9:40 pm

    “Accept the possibility that you might be getting played before you spend any money on this BS.”

    Wow. Totally not regretting the approximately $20 I spent on Robb’s book, considering I have listened to all his free podcasts at least twice! I don’t remember if he’s mentioned Paleo Brands more than 5 times in over a year’s worth of podcasts, so he’s hardly going for the hard sell. And I clearly remember him telling people that it’s better to cook real food than use any pre-packaged meals. More power to Robb for being able to make a living by teaching people how to live this way. He provides so much free information that is based on science rather than rhetoric.

    And I didn’t even need the book to go Paleo. I just bought it because a) I wanted to meet Robb Wolff at a book signing and b) I wanted to be able to show it to my patients, many of whom could benefit from a Paleo diet. But all the information anyone needs is available for free in the get started guide on this site.

    If this is getting played, I wish it would happen more often!

  38. LyssaBarnes
    January 15, 2011 at 7:25 pm

    Robb shouldn’t even bother to respond to this. Leave that to people like me who suffered from Celiac Sprue. I don’t care which so called professional wants to attribute a gluten-free diet to quackery. The proof is in the pudding. I will take their slander with a grain of salt any day than doubt the reality of the pain and discomfort I endured eating a “normal” diet.

    I can’t tell you what a blessing it is not to have to visit a bathroom every 10 to 15 minutes, finally be able to get some sleep, and spend time with my family instead of being confined to a bed for lack of energy. Of course the weight loss is an added benefit. Did I happen to mention that I had previously gained over 30 pounds in 1 year on a vegan diet? It was my internist who addressed my gastric distress and weight gain by recommending that I return to meat eating.

    I can’t offer enough thanks to Wolf, Cordain, and the SCD community for the help I have received. It kept me from going under the knife.

  39. CanadianArcticPaleo
    January 15, 2011 at 7:52 pm

    I’m temporarily done eating an an anti-inflammatory….until Monday.

    I”m absolutely liquored off Molson Canadian and ready to rock tonight w00t w00t
    >>>(]-_-[)<<<

    Come party bobbyrobby

  40. KobeTony
    January 16, 2011 at 5:36 am

    How evil is gluten? Is it really as bad as plutonium for everyone?

    I have heard Robb mention such a sensitivity to gluten that even a few crouton crumbs left in a bowl where his salad is prepared will affect him soon afterward. Obviously Robb is super-sensitive, but I suspect most people who have grown up eating pasta and bread on a daily basis will not have such awareness.

    I also heard mention on the podcast that gluten can stay in the system for up to six months.

    Then there are all the quasi-Paleo people who have a cheat day and include a pizza, chocolate croissant, or a beer (or three).

    For someone not suffering from a known autoimmune disease, is a limited exposure (say once a week) to gluten going to condemn them?

    I say this as I did a full 30 days without gluten, felt good and noticed my eczema clear up, then went back to my weekend 2-3 weekend beers and notice no difference over the next 60 days (skin is still good). I want to believe in the Paleo gig, but also wonder if the gluten tolerance spectrum is larger than Robb makes out.

    • Robb Wolf
      January 16, 2011 at 8:18 am

      Kobe-
      “larger than I make out?” Try it, see what works? tinker? Really?

      I’m not telling anyone to BELIEVE in anything other than the science and personal N=1 experience. The point is you have a go-to option if you reach a level of intake that’s not working for you. Please, do not put words in my mouth on this.

      What I can tell you is we can track markers of inflammation with the grain consumption that INCREASES the likelihood of problems, but it’s not a guarantee. Let me know if this clarifies things.

      • KobeTony
        January 16, 2011 at 11:39 pm

        Thanks for the clarification.

        “Increases the likelihood of problems, but doesn’t guarantee them” does sound more moderate and along the lines of the “tinker and see what works” approach than the “plutonium” analogy.

        Sorry if it sounded like I was trying to put words in your mouth. Just that from 60hrs of podcasts, I was a bit confused by so many examples of how huge a problem is gluten is for many sick people, but hardly any information on what minor consumption does to a person not suffering from autoimmune disease.

        Of course “minor consumption” is a slippery slope, and I understand the logic in avoiding all contact with a substance that may cause us problems in the future.

  41. Erin
    January 18, 2011 at 5:36 pm

    The whole gluten intolerance thing is about to get a lot more interesting now that new saliva testing methods have been developed that test not one but 12 different components in wheat, cross-reactivity to things like dairy and coffee (yes, some people’s bodies think that coffee is gluten) and even are able to pinpoint which part of the body is being inflamed by the gluten.
    They found that the brain and nervous system are far more affected than anyone thought (a fact I discovered when I was researching bipolar disorder for a loved one and discovered heaps of people claiming that gluten was their trigger!)

    This is really cool because these tests can help predict future autoimmune issues before they manifest into full-blown conditions!
    http://drknews.com/what-type-of-gluten-intolerance-do-you-have/

    • Robb Wolf
      January 18, 2011 at 6:52 pm

      Yea, this is all fascinating stuff.

    • KobeTony
      January 18, 2011 at 8:52 pm

      It sounds like a great test that would probably answer a lot of questions.

      My only worry is that this is a for-profit deal designed to rake in the dough on a hot topic. I would like to see some MDs on board rather than “Dr. K’s” credential degree list that looks like it was written to be more impressive than it actually is (not as bad as T.S. Wiley though).

      • Robb Wolf
        January 19, 2011 at 7:46 am

        I’m going to check it out but from what I’ve heard Dr. K is legit. Have never met or talked, but he seems on the right track. And if the diagnostics do what they claim…no problem in profiting from that IMO.

  42. qualia
    January 21, 2011 at 3:29 pm

    slightly off topic, but what do you think about this?
    “Is Candida albicans a trigger in the onset of coeliac disease?”
    http://www.ncbi.nlm.nih.gov/pubmed/12826451

    i’m a bit shocked. that would explain A LOT, for A LOT of people. namely, for all people that got gluten sensitive after antibiotics, like me (lethargy and diarrhea). i have no proof of course, but it would make chronological sense, incl. the onset of a ton of new food allergies (basically to almost everything i regularly eat), and a persistent low-grade inflammation of the small intestine, even still today, being gluten and dairy free for several months now. intuitively, i always had the feeling that it must be SIBO or candida or something at the beginning of it, because of the ultra-fast reaction time after ingestion of food (within minutes). i even got me some nystatin despite the disbelief of my doc (“candida is a myth”), which indeed massiveky improved the symptoms, but then run out of it, and didn’t immediately renew the prescription, and then “forgot” about it (this stuff is pretty expensive here). need to try it again, but this time for a few weeks, not just a few days.

    what do you think of candida as a direct molecular trigger of celiac or gluten sensitivity? ever had a client of yours where candida (e.g. after antibiotics) was an actual and proven cause of a digestive or gluten problem, that maybe even resolved after getting rid of the fungus?

    • Robb Wolf
      January 22, 2011 at 10:08 am

      I think dysbiosis is a huge player in this, but not just candida.

  43. Janeway
    February 23, 2011 at 5:08 pm

    As Robb points out, there’s no “one size fits all” when it comes to diet. Paleo is challenging for many people because we’ve been so conditioned to turn over our decision-making skills to supposed experts who are going to tell us exactly what to do, how and when to do it, and exactly what the results are going to be. You can get a groovy T-shirt if you like, but there’s no secret decoder ring or handshake that goes with eating Paleo.

    Real people with real physiology and real genetics can’t be categorized that way. Sorry, all you skeptics. You’re going to have to actually experience the Paleo diet yourself for at least a month to understand how it works for you. And no cheating!

    Regarding gluten: Having discovered, through trial, error and the ingenious hypothesis of a chiropractor, that I was gluten-intolerant almost 30 years ago, I had reached a moderately stable level of health. I no longer had the allergic reactions of gluten-intolerance that had plagued me, mainly migraines, constant sore throats, and bad breath. Still, over the years I continued to gain weight and suffered from acid reflux, joint pain, sensitive teeth and gums and congestion. It wasn’t until I eliminated all grains, all beans and all dairy on the Paleo Diet that I lost the excess weight and did away with most of my chronic symptoms (still working on the arthritis).

    Gluten-free living was good, but Paleo living is way better. I suspect that many people would do better just cutting out all the non-ancestral foods, with or without gluten, and call it a day.

  44. GlutenFreeAthlete
    March 10, 2011 at 4:12 am

    Awesome putting it all out there! I run into this frequently!

  45. David R.
    April 9, 2011 at 5:39 pm

    Hi Robb – I asked a question on another blog about six weeks ago, because I’ve been taught forever that eating animal fats were going to land me on an Op Room gurney, and yes, it was before I’d read the whole book.

    Your comment was, “David, you need to re-read the book”. So I took your comment to heart and read it cover-to-cover, and then threw all the crap out of my cupboards and followed the plan. I started at 257.4, and six weeks later I’m at 232.2 (no heartburn, less joint pain, no headaches, tongue is actually pink, headaches gone, no need for Gas-X, better sleep … just wow!) I have more energy and feel great. I have three questions that are probably in the book, but I can’t find them. I know you’re busy, but please, just a “yes” or “no” would really be appreciated for now.

    1) Can we eat “gluten free” bread with no dairy in it?
    2) Is it all grains or just wheat, barley, etc.
    3) Isn’t corn a vegetable?

    Thanks so much.

    David

    • Robb Wolf
      April 11, 2011 at 11:47 am

      3rd time might a charm! This is all covered in The book. Not a fan of gluten free products except only occasionally, all grains are a problem, corn is a grain.

      • David R.
        April 12, 2011 at 4:56 am

        Hi Robb – thank you for the info. There is so much in the book that I often recall reading something and then it gets confused with other issues. Part of it is re-reading several times and making notes, which I’ll do over the next few months, but I wanted to be doing the right thing in the meantime. Thank you again.

  46. Josh
    April 14, 2011 at 10:13 pm

    I always get someone telling about how gluten free diets are bad for you. Thanks for the great post to reference!

  47. David
    April 29, 2011 at 4:47 am

    Hi Robb

    Thanks for spending all your day to put together some high-class info. So much appreciated! :)

    When looking for pancreatitis with your search function, this was the main article that shows up. So I guess it’s ok to plant the following question here:

    Do you have a good source of info online where I find what’s definietly forbidden to eat for someone who for sure suffers from lactose and fructose intolerance and also, very likely, suffers from Pancreatitis?

    Background of the question:

    A very good friend of mine in Germany (31 years old) very likeley suffers from Pancreatitis, doc says so but he’ll know more next week because he’ll have a thorough check this weekend in the hospital (maybe I should have waited for the results before writing this post?). He’s been suffereing quite a lot lately, symptoms seem to be indicating pretty much Pancreatitis. I want to see him try your diet for 30 days, as you propose, although in his case on short term he probably won’t get around the medication. But anyway. His additional challenge is that he’s suffering as well from lactose and fructose intolerance, poor guy… :) He’s kind of a ‘lazy bastard’ (not really meant in a negative way), so as a good friend I want to see what kind of info I can find for him so he doesn’t have any excuses that he has to do so much research to find what he’s allowed and not allowed to eat.

    Sorry to take up your time, Robb, but I definitly appreciate your answer! Of course, I will continue to promote your book to whoever I can, as I have been doing for the last 5 months.

    Best regards from Greece,
    David

    P.S.: I would hope to see sometime soon a box in the comment section that I can tick and get automatic notifications whenever you or someone else answers to a comment of mine. Makes life/following you so much easier and is actually a standard service in most WP themes. Thanks!

    P.P.S.: What’s the situation regarding the translations of your book, especially into German?

    • Robb Wolf
      April 29, 2011 at 8:26 am

      David! ship this to the podcast…older posts are only seen by me when the comments pop up, so this excellent question will otherwise be lost. German edition is in process…couple of months…hopefully!

      • David
        May 21, 2011 at 8:37 am

        Hi Robb

        I looked into the Table of Contents of the last podcasts but couldn’t see any subject that seems related to my above question, regarding chronic pancreatitis and obviously also lactose/fructose intolerance. Can you let me know if you have treated that subject already or when you plan to do so?

        In case still to be done:
        10 days out of the hospital my good friend is still on heavy pain killers, otherwise he can’t make it, definitely not through the night. Doctors told him at the hospital that maybe when he was told some years ago that he suffers from lactose/fructose intolerance, this maybe wan’t it but the beginning of the pancreatitis. But nothing seems a 100% sure.

        When you treat this subject in your podcast I’d like to ask you to let me know in how far you think this can -at this time- indeed be treated with the right kind of food and which that would be exactly in his case.

        Thanks, also in the name of my good friend!

        David

        • Robb Wolf
          May 21, 2011 at 1:30 pm

          David-
          It’s a huge topic…do some looking under pancreatitis and gluten for starters.

          I wish I had 3 or 4 of me…so much stuff that needs to be written.

          • David
            May 23, 2011 at 2:21 am

            Thanks Robb! I appreciate your answer, as it at least helps me to understand that you indeed think that there’s a connection between gluten and Pancreatitis.

  48. Alex
    May 7, 2011 at 5:55 pm

    Robb,

    Just wanted to point out a response to these studies from Darya Pino over at summertomato.com

    So I’ll say upfront that I clearly haven’t read as much about gluten as Robb, but I do understand biology and biochemistry and can comment on the evidence he’s presented here. I’ll look more into this stuff in the future–probably for an episode of STLive.

    Starting at the beginning, I’m not impressed with his first study that he says proves “everyone experiences gut irritation from gluten”. Why? Because you cannot compare healthy people to disease patients and extrapolate on health consequences. My favorite illustration of this is with sickle cell anemia. This is a genetic disease that causes all sorts of problems with red blood cells. People with 2 copies of the mutant gene have the disease (we all agree it sucks), people with one copy do not have the disease but have a mild sickle cell phenotype (viewed under a microscope) with no physical consequences. This is called a recessive trait. These people are otherwise healthy, but can still pass the mutation to their children.

    If the mutation is recessive and very bad for you when there are 2 copies, why is it so common in the gene pool? Shouldn’t nature have selected against sickle cell? Turns out having one copy of the mutation actually protects against malaria. So people in certain tropical regions of Africa had a better chance of surviving malaria because of this “defect” in their blood.

    Biology is complicated, we get into trouble when we try to oversimplify.

    In the study Robb presents, the researchers compare celiac to healthy intestine, which shows a slightly similar but reduced effect to gluten. Nowhere does this study prove that this reduced effect is bad for healthy people. It is what it is, but I’d like to see more evidence before jumping to conclusions that this is dangerous.

    As for the second study, I’m not at all surprised to hear that diets that include processed grains have higher rates of insulin resistance. This is non-debatable in my opinion. But there are a couple things to consider before writing all grains off. First, insulin resistance is not the only measure of health. Certainly small amounts of grains, particularly intact grains (rather than processed) do not cause insulin resistance and type 2 diabetes, large quantities of processed grains do. Moreover, there may be other benefits of eating these small amounts of unprocessed grains irrespective of metabolic health. For example, the value of soluble fiber and other micronutrients may not be measurable with a simple blood test. There are potentially thousands of other factors that may be at work.

    Moving on, while I agree insulin is hugely important in metabolic health, I don’t see the value in arguing it when discussing people whose levels are stable (like me). In his 3rd study, Robb again points to results in disease patients and extrapolates to healthy people. Grain free may indeed be better for people with heart disease and type 2 diabetes–these people have already gorged themselves on grains. Does that mean I should give up eating oatmeal and farro? I’m not convinced. Also, I question the methods of a study that includes “margarins” in a description of a Mediterranean diet. Obviously trans fats aren’t helping anyone and are known to cause heart disease.

    Robb and other Paleo proponents deserve a lot of credit for encouraging people to embrace a more natural diet and arguing for the health of animal products. I also think it’s possible to live healthily without grains. But I do not think it’s necessary for everyone (for some in may be), and adding just small amounts makes life a lot more pleasurable for most people.

    • Robb Wolf
      May 8, 2011 at 9:00 am

      Yea, I saw that. this stuff can just go around and around. Mat Lalonde has talked at length with Fassano…we are on point with this stuff, folks need to stay up on the literature.

  49. Chris Armstrong
    July 8, 2011 at 2:09 pm

    It frustrates me greatly that the words gluten-free are so often misaligned with healthy eating. I’ve seen it in the gluten-free aisle at my local Whole Foods where a person will pick up a box of gluten-free cookies and say, “these are supposedly good for you”. As I tell people that ask me about a gluten-free diet, if you’re looking to the gluten-free diet for its health benefits, stay away from anything labeled gluten-free, stick to real food that is naturally gluten-free (and grain-free). If you’re eating gluten-free because of being diagnosed with celiac disease, but you have no interest in changing your diet that got you in trouble in the first place, the myriad of gluten-free cookies, loaf bread, and other products that line the shelves of the supermarket are made just for you.

    Thank you for the great post Robb. I’ll definitely be sharing. Thanks.

  50. Grant Putnam
    November 10, 2011 at 10:25 am

    At the table its good to add rice vineger with finely chopped large chillies and a touch of sugar also.[as they do in thailand]

  51. matt
    November 29, 2011 at 10:45 pm

    Thnx Alex – Robb is a proud science man who is blind to the scope of life outside of his mundane materialistic world…Many people all over the world are healthy eating some degree of gluten -however people with sensitivity seem to project it upon others…I am surprised at how many people are ignorant about one of the worlds’ best cancer cures http://www.youtube.com/watch?v=wvrBlG8-7k8
    http://www.youtube.com/watch?v=o-laG4GhyfE&feature=related
    If someone does not react well to a food or medicine, many people create a holy war against it…People should look at the big picture and work together to stop the pharmaceutical Genocide and work together for an organic future~

  52. Tim
    February 8, 2012 at 2:06 pm

    So, there’s a story that goes around my family about my grandfather who was a very accomplished and respected Home construction/contractor/hvac type. He grew up in a time when you learned on the job and experience meant FAR more than any piece of paper or capital letters after your name.

    Towards the end of his career, he was designing and was his own GC on the house he was having built for his retirement. It was literally his “dream home” that he designed from the ground up. During the process, a young inspector came out and started to question him on the design in his plans for ductwork in and out of the furnace, consistently saying over and over again that there wasn’t sufficient this or that (sorry the details of the story have faded over time) until finally my grandfather said, “Sit down son…” and pulled out a pencil and proceeded to carefully draw and explain the rationale for the entire design. He did this from memory and apparently was quite convincing as the inspector ultimately signed off the plans as designed.

    Upon reading the first part of this post, I had a mental image of Robb saying, “Sit down, son…”

  53. Ingrid
    March 28, 2012 at 1:15 pm

    I recently saw something on the Today Show that went even further then this jerk- they were telling people to go back to eating gluten if they had made the ‘mistake’ of self-diagnosis. I haven’t been able to watch since. I won’t even start on how undiagnosed celiac ravaged my toddler or caused me years upon years of misery, I will just say that when I ‘self diagnosed’ three years ago, those three years up until finally having a test confirm celiac were a hell of a lot better than they would have been if I had listened to this ass. I am going to refer all doubters I know in my personal life to this article. I am sure that it does indeed feel like a losing battle, but Robb, your book changed my life when I was vegan and still eating a ton of grain- thank you for being the voice of reason in our disgusting, messed up society!

    • Robb Wolf
      March 28, 2012 at 3:28 pm

      It’s wacky…we are telling folks to eat FRUITS AND VEGGIES! Not lick doorknobs or mainline crystal meth! Not only is the gluten a far reaching problem, these other foods are clearly more nutritious.

  54. mad
    April 21, 2012 at 11:48 am

    Come on Robb When are you going to Give up your Caffeine addiction & get natural energy from your Diet & Natural Energy Herbs? I guess all the Bacon must way ya down and you need the toxic boost!

  55. believefit
    April 22, 2012 at 8:10 am

    Rob- like you have said “do it or don’t, there is no try” I have eaten gluten free to try to diagnose stomach issues and learned a lot about gluten on the way… All we can do is educate ourselves and DO IT!! If it works, great! I won’t say “If it doesn’t, fine” because IT WILL WORK!! I had a patient with such a gluten allergy that she can’t even touch wheat flour to help her grandma make cookies or her hands get a rash. Her face kept breaking out and found out there was gluten in her makeup!! Don’t tell me something can cause those issues for some people and NOT be bad for ALL people!! And paleo isn’t just gluten free, it’s grain free. I’m amazed at how awesome my stomach feels 6 weeks in, after 6 years of random “attacks.” I will remain forever Paleo because I DID IT, and it WORKS!

  56. James Phelps
    April 23, 2012 at 7:00 pm

    Thanks Robb,
    Mabey when you get a redundant post you could just send what you wrote this time! Good reading!
    Well I am going on week 3 now :^) all my rheumatoid symptoms and pain is at the lowest ebb all year, odd this is when they peak too including my asthma and allergies.
    I thought the scale was broken when I was at the recreation center this week end – I lost a bloody 20 lbs! I am now 1 pound lower than last yr when I was getting up at a horrid hour and swimming a mile every day and feeling like a better crap than the crap before the paleo but crap nonetheless. I swam about 6 sprints with rests between and felt so good the next day I thought it should be perhaps illegal.
    Ps you should put my recipe for parsnip cream sauce in your stuff – even non-paleo eaters liked It better than cow cream sauce. Ok here 4 Large parsnips, 1 onion, coconut milk as needed. Steam the parsnips and onion till soft enough to purée then purée with coconut milk to desired sauce consistency and add to make creamed carrots or other veggies.

  57. julie
    February 9, 2013 at 8:02 am

    I don’t have problems with gluten, grains, beans, anything but sour cream.

    I’m SO lucky that I lost 60 pounds, and I can still eat a daily cookie.

    I’m sorry you all have such health problems. You must be a lot of fun at parties, bitching and moaning about your sensitivities and how you know better than everyone else. Those researchers who don’t agree with you are sell-outs! Or just dumb and trying to oppress you with their bread.

  58. Grant Curle
    April 3, 2013 at 2:20 pm

    Bravo!

    A counter argument not based on cutting a chicken’s head off and shaking it all around. Eating in the paleo manner is doing wonders to control my symptoms from Hashimotos Thyroiditis and the sinus arrhythmia that I have been dealing with for my whole life is gone.

    Sorry ’bout your luck Brian…

    • RM
      September 11, 2013 at 11:45 pm

      Amen to that. When I manage to eat paleo I have no acid reflux and my Hashimotos seems to be much better.

  59. RM
    September 11, 2013 at 11:44 pm

    The best thing for cortisol issues is following a Paleo diet. Has anybody read Datis Kharrazian’s book “Why do I still have thyroid symptoms if my tests are normal?”. That thing is my bible. I always refer to it because I and my kids have autoimmune disease, and it gives info on immune modulation, the role of gluten in thyroid disease and other autoimmune diseases, and tips on how to build glutathione. It gave me the magic tools to help my son with PANDAS, autism and lyme disease (and low level Hashimotos). For cortisol issues, Kharrazian recommends a grain free and lower starch diet, and avoid gluten and casein. That’s pretty much paleo. The grains and starches make your blood sugar rise and fall constantly, further stressing your adrenal glands. Eventually, you get things like diabetes, hypoglycemia, adrenal failure, etc.

  60. Francesco Scardigno
    October 16, 2013 at 5:04 am

    Cheers to that rebuttal Rob! Thorough!

  61. Megan
    December 24, 2013 at 1:59 pm

    Wow! This is an amazing article, and I have to say that your approach is the one that warrants the most credibility. I often struggle with a lot of the misinformation put out there, your sensible and scientific approach is a bright spot in the array of information that usually just leaves me confused.

    Thanks!

  62. Mike C.
    January 7, 2014 at 7:15 am

    Any comments on this? – http://nutrevolve.blogspot.com/2013/12/re-gluten-free-diets-are-backed-by.html

  63. Fiona Matthews
    March 21, 2014 at 4:03 am

    as a parent of an autistic child i have to say that being glutin free for the last 5 years has been a god send.
    As soon as we went GF we noticed a marked reduction in some of the more overt Aspie type tendencies.. now you would have to know to guess that he is on the spectrum.

    But.. if he accidentially gets some glutin.. then its back to the hand flapping and other issues until we can get it out of his system…
    All in his mind.. i dont think a small boy can fake it for so long

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